Use of Alendronate in Postoperative Period for Prevention of Hip Implant Aseptic Instability

Full Text

Abstract

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).

References

  1. Миронов С.П., Родионова С.С., Колондаев А.Ф. и др. Схемы назначения препаратов, регулирующих интенсивность стрессового ремоделирования вокруг имплантата, при эндопротезировании тазобедренного сустава: Пособие для врачей. - М., 2002.
  2. Родионова С.С., Нуждин В.И., Клюшниченко И.В. и др. Курение и злоупотребление алкоголем как факторы риска развития нестабильности эндопротезов тазобедренного сустава //Вестн. РАМН. - 2008. - N 9. - С. 6-12.
  3. Флетчер Р., Флетчер С., Вагнер Э. Клиническая эпидемиология (основы доказательной медицины). - М., 2004.
  4. Espehaug B., Havelin L.I., Engesaeter L.B. et al. Patient-related risk factor for early revision of total hip replacement (A population register-based case-control study of 674 revised hips) //Acta Orthop. Scand. - 1997. - Vol. 68. - P. 207-215.
  5. Hilding M., Ryd L., Toksvig-Larsen S., Aspenberg P. Clodronate prevents prosthetic migration: a randomized radiostereometric study of 50 total knee patients //Acta Orthop. Scand. - 2000. - Vol. 71. - P. 553-557.
  6. Holick M.F., Matsuoka L.Y., Wortsman J. Age, vitamin D and solar ultraviolet //Lancet. - 1989. - Vol. 2. - P. 1104-1105.
  7. Kiratli B.J., Heiner J.P., McBeath A.A., Wilson M.A. Determination of bone density by dual x-ray absorptiometry in patients with uncemented total hip arthroplasty //J. Orthop. Res. - 1992. - N 10. - P. 836-844.
  8. Kold S., Bechtold J., Mouzin O. et al. Fixation of revision implants is improved by surgical technique to crack the sclerotic bone //Clin. Orthop. - 2005. - N 432. - P. 160-166.
  9. Korovessis P., Piperos G., Michael A. et al. Bone mineral density changes around stable uncemented Zweymuller total hip arthroplasty //Int. Orthop. - 1997. - Vol. 5. - P. 389-396.
  10. Lai K., Shen W., Yang C. et al. The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis //J. Bone Jt Surg. - 2005. - Vol. 87A. - P. 2155-2159.
  11. Meraw S., Reeve C.M. Qualitative analysis of peripheral peri-implant bone and influence of alendronate sodium on early bone regeneration //J. Periodontol. - 1999. - Vol. 7, N 10. - P. 1228-1233.
  12. Millett P.J., Alen M.J., Bostrom M.P. Effects of alendronate on particle induced osteolysis in a rat model //J. Bone Jt Surg. - 2002. - Vol. 84A. - P. 236-249.
  13. Nehme A., Maalouf G., Tricoire J.L. et al. Effect of alendronate on periprosthetic bone loss after cemented primary total hip arthroplasty: a prospective randomized study //Rev. Chir. Orthop. - 2003. - Vol. 89, N 7. - P. 593-598.
  14. Nishioka T., Yagi S., Mitsuhashi T. et al. Alendronate inhibits periprosthetic bone loss around uncemented femoral components //J. Bone Miner. Metab. - 2007. - Vol. 25, N 3. - P. 179-183.
  15. Radl R., Hungerford M., Materna W. et al. Higher failure rate and stem migration of an uncemented femoral component in patients with femoral head osteonecrosis than in patients with osteoarthrosis //Acta Orthop. Scand. - 2005. - Vol. 76, N 1. - P. 49-55.
  16. Rosenthall L., Bobyn J.D., Brooks C.E. Temporal changes of periprosthetic bone density in patients with a modular noncemented femoral prosthesis //J. Arthrplasty. - 1999. - Vol. 14. - P. 71-76.
  17. Rubash H.E., Dorr L.D., Jacobs J. et al. Does alendronate inhibit the progressions of periprosthetic osteolysis? //Trans. ORS. - 2004. - Vol. 29. - P. 1492.
  18. Schacht E. Rationale for treatment involutional osteoporosis in women and for prevention and treatment of corticosteroid-induced osteoporosis with alfacalcidol //Calcif. Tissue Int. - 1999. - Vol. 65. - P. 317-327.
  19. Soininvara T.A., Jurvelin J.S., Miettinnen H.J. et al. Effect of alendronate on periprosthetic bone loss after total knee arthroplasty: a one year randomized controlled trial of 19 patients //Calcif. Tissue Int. - 2002. - Vol. 71. - P. 472-477.
  20. Venesmaa P.K., Krцger H.P., Miettinen H.J. et al. Alendronate reduces periprosthetic bone loss after uncemented primary total hip arthroplasty: a prospective randomized study //J. Bone Miner. Res. - 2001. - Vol. 16, N 11. - P. 2126-2134.
  21. Wang C.J., Wang J.W., Ko J.V. et al. Thee-yars changes in bone mineral density around the knee after a six-month course of oral alendronate following total knee arthroplasty: a prospective randomized study //J. Bone Jt Surg. - 2006. - Vol. 88A. - P. 267-272.
  22. Wilkinson J.M., Stockley I., Peel N.F. et al. Effect of pamidronate in preventing local bone loss after total hip arthroplasty: a randomized double-blind controlled trial //J. Bone Miner. Res. - 2001. - Vol. 16. - P. 556-564.

Statistics

Views

Abstract: 106

Dimensions

Article Metrics

Metrics Loading ...

PlumX

Refbacks

  • There are currently no refbacks.

Copyright (c) 2009 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies